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General NPI Number Information
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NPI Number | 1861660920
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Entity Type | Organization
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Legal Business Name | CARNEGIE TRI-COUNTY MUNICIPAL HOSPITAL MANAGEMENT, INC.
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Dates
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Enumeration Date | 02/12/2008
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Last Update Date | 10/21/2021
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Provider Practice Location Address
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Address Line | 102 N. BROADWAY
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City | CARNEGIE
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State | OK
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Zip | 73015
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Country | US
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Telephone | 580-654-1050
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Fax | 580-654-2111
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Provider Business Mailing Address
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Address Line | PO BOX 97
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City | CARNEGIE
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State | OK
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Zip | 73015-0097
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Country | US
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Telephone | 580-654-1050
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Fax | 580-654-2111
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Authorized Official
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Title or Position | CEO
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Name | MR. SHANE BRADLEY DUNNING
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Credential |
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Telephone | 580-654-1050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 275N00000X
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Taxonomy Name | Medicare Defined Swing Bed Hospital Unit
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License Number | 2215
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License Number State | OK
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